| Objective:In this study,the clinical use of CTA(computed tomography angiography)and DSA(digital subtraction angiography)in the detection of carotid artery lesions is compared and analysed by collecting relevant data.The results of DSA are used as diagnostic criteria to assess the accuracy,sensitivity,specificity and consistency of CTA results by comparing and analysing the diagnosis of a particular disease,and to assess the value of CTA as a method of diagnosing carotid stenosis,plaque and collateral circulation.Materials and methods:A total of 137 patients with a proposed diagnosis of carotid stenosis were collected from January 2020 to June 2021 at the Department of Neurosurgery and Interventional Medicine of the Second Affiliated Hospital of Inner Mongolia University for Nationalities.Among them,90 patients were diagnosed with carotid artery stenosis.The DSA and CTA imaging data of all patients were observed,and the sensitivity,specificity,accuracy,positive predictive value,negative predictive value,and concordance of CTA in detecting carotid stenosis,plaque and collateral circulation were assessed using the DSA diagnostic results as a reference.Result:1.Among the 90 patients,there were 403 carotid artery stenosis.The Kappa value of CTA and DSA in the detection rate of carotid artery stenosis degree was above 0.8,and the detection rate of mild stenosis was 0.805.The two inspection methods Results were consistent in the detection of carotid stenosis.The sensitivity was 98.4%,the specificity was91.7%,and the accuracy was 98.1%.The kappa value of the moderate stenosis detection rate was 0.902,and the results of the two inspection methods were consistent in the detection of carotid artery stenosis.The sensitivity was 96.9%,the specificity was 93.3%,and the accuracy was 95.7%.The kappa value of severe stenosis was 0.891,and the results of the two inspection methods were consistent in the detection of carotid stenosis.The sensitivity was 97.1%,the specificity was 92.0%,and the accuracy was 95.7%.The occlusion detection results were consistent,and the sensitivity,specificity and accuracy were all 100%.2.Among the 90 patients,there are 157 collateral circulations.The Kappa value of CTA and DSA in the detection rate consistency test of collateral circulation is above 0.7,and the kappa value of no collateral circulation detection rate is 0.778.The results of the two inspection methods There is consistency in detecting no collateral circulation.The sensitivity was 89.1%,the specificity was 88.6%,and the accuracy was 88.9%.The primary collateral detection rate kappa value was 0.709,and the results of the two inspection methods were consistent in detecting primary collateral circulation.The sensitivity was 86.8%,the specificity was88.9%,and the accuracy was 87.4%.The detection rate of secondary collateral circulation kappa was 0.891,and the results of the two inspection methods were consistent in the detection of secondary collateral circulation.The sensitivity was 83.7%,the specificity was95.7%,and the accuracy was 90.0%.New blood vessels were all 0,the detection results were consistent,and the sensitivity,specificity and accuracy were all 100%.3.Among the 90 patients,there were 373 carotid plaques.The Kappa value of the consistency test of the detection rate of CTA and DSA in the degree of carotid plaque was above 0.6,and the detection rate of smooth plaque was 0.670.The results of the examination method were consistent in the detection of carotid smooth plaques.The sensitivity was 90.0%,the specificity was 88.4%,and the accuracy was 89.7%.Irregular plaque detection rate kappa value was 0.680,the results of the two inspection methods were consistent in the detection of carotid irregular plaques.The sensitivity was 88.3%,the specificity was 87.5%,and the accuracy was 88.2%.The kappa value of the ulcer detection rate was 0.794,and the results of the two inspection methods were consistent in the detection of carotid artery stenosis.The sensitivity was 85.7%,the specificity was 93.7%,and the accuracy was 89.7%.Conclusion:Based on the experimental results of this study,CTA has high accuracy,sensitivity and specificity in the diagnosis of carotid artery stenosis.Consistency analysis showed good agreement between CTA and DSA.For intracranial collateral circulation and carotid plaque,the diagnostic value of CTA was moderate.With the continuous development and advancement of CTA imaging technology,the ability of CTA in diagnosing cerebrovascular diseases will become closer to,and in some aspects superior to,DSA,and it also has the advantages of being non-invasive,safe,convenient and fast.Therefore,CTA can basically replace DSA as the test of choice in the emergency evaluation of carotid artery disease or in routine screening for carotid artery disease,but it is not yet possible to conclude that CTA can completely replace DSA as the gold standard for the diagnosis of carotid artery stenosis. |
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